Crohn’s Disease is a type of inflammatory bowel disease that can go into remission but then suddenly reappear with nasty symptoms. Doctors may prescribe medication or, in severe cases, even surgery.

Good lifestyle choices and general symptom management can help ease the hardships of this disease.

Here we will look at examining what the disease entails and the best treatment options available today.

 

What is Crohn’s Disease?

 

Crohn’s disease falls under the category of inflammatory bowel diseases. As such, it’s a condition that stays with those suffering from it for life.

While it does differ quite significantly from inflammatory bowel disease, Crohn’s disease does involve chronic inflammation of the digestive tract.

The hardest part about living with Crohn’s disease is living with life-disrupting symptoms. Even when symptoms are not present, though, the disease can be a real hindrance to a stress-free life because Crohn’s disease is prone to remission with sudden flare-ups a common occurrence.

Lifestyle changes are required by most people living with the disease to manage the disease as carefully as possible in an attempt to lower its negative effects on normal school, work, and social life.

In this article, we will look into what makes Crohn’s disease part of the Inflammatory Bowel Disease umbrella term, how it differs from ulcerative colitis, the typical signs and symptoms one can expect when dealing with Crohn’s disease, and potential treatment options.

 

  

Inflammatory Bowel Disease and Crohn’s Disease

 

Crohn’s disease is a form of inflammatory bowel disease (IBD).

IBD is the collective term for describing disorders that involve chronic inflammation of the digestive tract. The digestive tract is comprised of everything from the mouth and oesophagus through to the small and large intestine.

The digestive tract is what keeps you alive by breaking down your food, retaining the valuable parts, and ridding itself of the rest.

The definition of IBD is broad in scope but defines the parent term for two sub-categories of IBD, namely ulcerative colitis and Crohn’s disease.

It’s important to note that while we can draw clear separations between the two on paper, it can sometimes be quite a tricky task to diagnose the correct IBD in patients.

That said, let’s take a look at how Crohn’s disease is similar and contrasting to ulcerative colitis.

 

How is Crohn’s Disease Different from Ulcerative Colitis?

 

Ulcerative colitis involves inflammation of the large intestine with inflammation only present in the innermost layer of the lining of the colon.

Apart from inflammation, ulcerative colitis can also present as sores, or ulcers, on the colon lining. Another characteristic of this form of IBD is that the damaged areas are continuous.

This is in contrast to how Crohn’s disease presents.

Whereas ulcerative colitis is limited to the large intestine, Crohn’s disease can involve any part of the gastrointestinal tract from the mouth all the way to the end – the anus. 

Most commonly, it develops in the final part of the small intestine and colon. Another differentiating factor is that it occurs in distinct patches.

Unlike the continuous inflammation found in ulcerative colitis patients, those suffering from Crohn’s disease present with quite distinct healthy and inflamed areas of tissue.

Crohn’s disease seems to be increasing in occurrence with time – studies in the United States suggest that over half a million people are suffering from the disease.

The distinction between the two forms of IBD is not always crystal clear.

When a doctor is unable to determine whether a patient has ulcerative colitis or Crohn’s disease, they will classify the patient’s condition as “indeterminate colitis” implying that there are cases where it’s not always clear one way or the other.

 

 

Signs and Symptoms of Crohn’s Disease

 

Due to the involvement of the small or large intestine and the fact that inflammation can be spread out in multiple segments, signs and symptoms can be widespread.

When Crohn’s disease is in remission, that is to say, that when inflammation is not severe, patients will present with no signs or symptoms. This can change quite rapidly though and often without warning.

When Crohn’s disease is fully active (i.e. not in remission), a number of signs and symptoms can be found, some more painful and debilitating than others.

Depending on the location of the diseased inflammation, symptoms can vary with inflammation of the lower gastrointestinal tract possibly including some or all the following symptoms: 

• Abdominal pain and cramping
• Fatigue
• Reduced appetite and weight loss
• Persistent, sudden diarrhoea
• The sensation of incomplete bowel evacuation
• Constipation which could lead to bowel obstruction

Some of these symptoms may also be present if Crohn’s disease is in the upper GIT but symptoms are fewer in number and milder in severity.

Crohn’s disease has even been known to present silently (no outward symptoms) when the disease affects the small intestine. What often happens is that those with silent symptoms later exhibit symptoms such as intestinal blockage, infection, or persistent pain and fever.

There are also several symptoms, already touched on earlier, that affect one’s general health such as mouth sores, night sweats, and unusual menstrual cycles.

In more severe cases, patients with well-established Crohn’s disease may also experience inflammation of the skin, eyes, and joints, iron deficiency, delayed growth in children, and even kidney stones.

There is quite a range of displayed signs and symptoms of Crohn’s disease. It’s important to remain vigilant in monitoring one’s own health and consulting your doctor at any sign of irregularity in one’s health when Crohn’s disease is suspected. 

 

 

Treatment of Crohn’s Disease

 

Due to the inflammation being the main problem in Crohn’s disease with cascading effects, anti-inflammatory drugs are the first step in a treatment plan.

Before starting a treatment plan, one’s doctor will first check out what kind of complications might be present, the severity of the symptoms and other medical conditions that may be present.

Apart from this, the doctor will want to understand how one’s body has responded to medication before such that he or she can ascertain what medical route to go down. Understanding potential side-effects are the primary goal here.

Apart from reducing inflammation, it is important to lower the immune response in an attempt to stop the immune system from attacking the bowel which causes inflammation. Immune suppressants are administered for this.

An example of an immune suppressant that may be administered is a corticosteroid that can help ease swelling. Immunomodulators can be given to stop inflammation but these are more intense and can take weeks or months to kick in.

Aminosalisylates are likely prescribed when one is diagnosed with Crohn’s disease but only present with mild symptoms.

There are risks of side effects with any medication, so doctor consultation is important to establish the right medication on a case-by-case basis.

Antibiotics can also be administered to target bacteria that may be triggering or worsening Crohn’s disease symptoms.

Once the main symptoms have been dealt with, it’s important to maintain good lifestyle choices to further reduce symptoms and risk of re-onset. This includes addressing the loss of fluid by drinking plenty of water and avoiding potential bowel irritants such as dairy products.

In some cases, surgery can be necessary.

For people with Crohn’s disease, surgery can be a means used to remove affected parts of the intestine.

 

 

 

Get in Touch with GI Experts

 

To learn more about the complexity of your gut and the opportunity for you to contribute to the scientific pursuit of gastrointestinal knowledge, visit our Cape Town office or peruse our website.

We are gastroenterologist experts using patient-focused GI treatment and procedures in Cape Town

Stomach pain can be a tricky condition to diagnose. First off, it’s quite the general term and isn’t really enough to go on and make a clear self-diagnosis without the completely plausible risk of being horribly off the mark.

Stomach pain also varies wildly in intensity due to the large degree of variation in cause and location.

Nuances in location and cause mean it is in your best interest to seek an actual medical professional when you’re dealing with stomach pain.

In short, if you’re wondering if you should see a doctor about your troubling stomach pain then you probably should.

That said, there are pointers that can make it easier for you to determine whether a trip to the doctor is necessary.

Understanding the types, sources of stomach pain, and common stomach pain signs can change your thinking from “I wonder if it’s worth seeing the doctor about this” to “Oh I recognize that sign, I should definitely see my doctor about this.”

So let’s first jump into the different types and sources of stomach pain and then explore some of the stomach pain signs to be on the lookout for in determining whether to see a Gastroeneterologist.

Types and Sources of Stomach Pain

Stomach pain can often be confused as pain that isn’t the stomach at all but rather the abdominal region.

The abdomen includes not only the digestive tract but also other vital organs such as the large intestine, stomach, appendix, kidneys, liver, and gallbladder.

Apart from these organs, your abdomen houses muscles, bones, blood vessels and other structures.

There is simply a lot going on in the abdomen and, as such, any problem with one of these structures may cause pain in the abdomen.

Due to the sheer complexity of what’s housed in the abdomen, there is a vast array of potential problems that may cause pain.

Some of the more common sources of pain include indigestion, gastroesophageal reflux disease (GERD), kidney stones, appendicitis, irritable bowel syndrome and a whole host of others.

One of the most common causes of stomach, or abdominal, pain is related to bloating and gas where a generalized pain is felt most often due to indigestion.

The pain, as you are likely aware, is uncomfortable but normally resides after some time.

Taking an over-the-counter medication such as an antacid can lower the recovery time significantly but often normal digestion will resume with time and the pain will subside.

This general pain is different from abdominal pain that is more localized to a certain region. This may indicate a sign of a problem with one of your organs.

Before you panic whenever you feel localized pain, know that this pain may be transient in nature thereby passing with time.

However, a sharp, persistent, or worsening localized pain may indicate a good time to see your doctor.

Stomach Pain Signs for When to

See a Gastroenterologist

General pain is, well… pretty general. As such, it can be difficult to discern between pain that may subside in a short while and acute pain that requires more serious attention.

To help one make sense of and differentiate between something that will shortly subside and that which may be a sign of something more troubling, let’s take a look at several stomach pain signs that justify a visit to the doctor.

1.   Intense Pain Accompanied by Bloody Diarrhoea

If this appears quite suddenly, it can serve as a sign of something like a foodborne illness thanks to food contamination of some sort.

Salmonella and E. Coli are both causes of foodborne illnesses. Food poisoning is often accompanied by other symptoms such as running a fever.

While food poisoning does generally subside in a few days, it is worth a visit to the doctor even if just to ensure that food poisoning is indeed the cause and whether additional precautionary measures need to be taken.

Regular severe pain coupled with bloody diarrhoea, on the other hand, could suggest something more serious such as a form of inflammatory bowel disease like ulcerative colitis.

The tricky aspect of something like inflammatory bowel disease is that it may have periods of remission where the pain and general symptoms disappear. This can provide a false sense of recovery to patients.

Ultimately, intense pain accompanied by bloody diarrhoea warrants a visit to the doctor every time.

2. Sudden Pain Paired with Vomiting

As in the previous sign, this could be an indication of a foodborne illness. And, as mentioned earlier, this may pass after several days.

These symptoms can, however, be the cause of acute gastroenteritis (‘stomach flu’). Gatroenteritis is caused by a bacteria, virus or parasite and manifests as inflammation of the intestine lining.

Viral gastoenteritis is very common today and generally subsides on it’s own. As such, it’s not essential to see a Gastroenterologist but if you are struggling to keep fluids down then a visit to the doctor is needed.

3. Intense Stomach Pain in Lower Abdomen

If one experiences a high level of pain in the lower abdomen that is relieved once the bowels are moved, it could be a sign of irritable bowel syndrome (IBS).

IBS involves a change in the normal functioning of the digestive system and is related to how the brain and the gut work together.

Those with IBS tend to have more sensitive guts resulting in changes in muscular contraction in the bowels. Symptoms include bloating, constipation, and persistent stomac pain, among others.

Due to the fact that stomach cramps that subside after the moving of one’s bowels can be a sign of constipation, the lines between IBS and ordinary constipation can become a little blurred.

If constipation is something you find reoccurring on a regular basis then a visit to the doctor may do you some good in helping to clear up the causes and looking at possible solutions.

4. Side or Lower Back Pain

Kidney stones may be the problem if you experience side or lower back pain coupled with pain during urination.

Kidney stones are tiny pebble-like crystals that can form in one or both of the kidneys due to high levels of certain minerals.

The pain caused by kidney stones is due to their sharp crystalline structure passing through the urinary tract as tries to leave your body.

The pain can be quite incredible and is often accompanied by nausea and even vomiting.

Summary

Stomach pain and that in the surrounding abdominal region can be quite mild.

In the majority of cases, pain in this area is related to indigestion and bloating and does not always require a trip to the doctor.

If pain persists for a longer period of time or worsens, then it is time to seek professional medical help.

Localized pain, that is pain felt in a specific region of the abdomen, may indicate a more severe problem and certainly warrants paying the doctor a visit.

In any case, if you are unsure whether you should or shouldn’t see a doctor, then the answer is always that you should.

Don’t rely on internet blogs and articles to self-diagnose as this can be dangerous for your health and should not be taken as medical advice.

Always trust the professionals as they are trained to diagnose and help you recover.

Learn More from the Experts

GiDoc Cape Town is a practice founded to provide medical solutions in the area of gastroenterology.

Over the years, Dr Eduan Deetlefs has earned the reputation of a trusted health expert providing consultative, diagnostic, and therapeutic endoscopic and related services to patients in Cape Town and beyond. 

Book an appointment online or give us a call at 021 551 8678 to find out more.